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Member Application:

* Company Name:

Phone:

Referred by:

Mailing Address:

City/State/Zip:

Country:

* Business Category:

Comments/Questions:

Primary Contact Information:

* Name (First / Last):

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* Phone:

Cell Phone:

Fax:

* Email:

Contact Preference:

Email Phone

Address:

Same as Company Address

City/State/Zip:

Country:

Membership Package:

	Newly-started Corporations: $750.00 Annual membership benefits for THREE designated employees, plus one-time 1/2 page ad in The Consumer Advocate or a one-time 5-minute radio interview.
	Small Business: $450.00 Annual membership benefits for TWO designated employees, plus one-time 1/4 page Ad in The Consumer Advocate or 2 sixty seconds radio promo.
	Clergy or Non-Profit: $250.00 Annual membership benefits for TWO persons (one must be Clergy Leader or Executive Director, plus 5-minute radio interview)
	Individual: $175.00 Annual membership benefits, plus one-time free listing in The Consumer Advocate.
	Full time Student: FREE - Copy of student ID required
	Veterans: FREE - Veterans' ID required

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718-722-9217

Member Application:

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